There are various types of medications used to prevent migraine attacks in people living with migraine.
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What Are Migraine Preventive Treatments?
Medications that can be prescribed to helpprevent migrainesinclude:
Preventive medicines are taken regularly.
Getty Images / NickyLloyd
Some medications are taken daily, while the newer, injectable medicines are taken every one to three months.
Some goals of preventive therapy are:
Preventive vs. ## Do You Need Migraine Preventive Treatment?
However, other antidepressants may be prescribed.
Amitriptyline
Amitriptylineis part of a group of drugs calledtricyclic antidepressants.
The Food and Drug Administration (FDA) approved amitriptyline to treat depression.
However, it is also used off-label to prevent migraine.It works by increasing levels of the neurotransmittersnorepinephrineandserotoninin the brain.
What Is Off-Label Use?
This can happen if the provider determines that the medication is medically appropriate for the user.
Effexor XR is FDA-approved to treatdepressionandanxietydisorders.It is also prescribed off-label to prevent migraine.
Like amitriptyline, venlafaxine works by increasing norepinephrine and serotonin in the brain.
They are similar in effectiveness.
Studies show that both drugs are effective and well-tolerated.
Topamaxand Depakoteare both FDA-approved to prevent certain types of seizures, as well as prevent migraine.
However, these drugs should not be used in pregnant individuals because they could cause harm to the fetus.
Both are effective and well-tolerated.
However, they should not be used by pregnant people.
Beta-Blockers
Beta-blockersare medications used to treathigh blood pressureand other heart-related conditions.
There are various beta-blockers available.
Botox is injected every three months into 31 specific points where nerves are active during migraines.
It may help people with 15 or more headache days per month.
Some research concludes all calcium channel blockers have conflicting or inadequate evidence to support their use for migraine prevention.
However, they are no longer considered effective for migraine prevention and generally are not recommended for this use.
CGRP Inhibitors
Calcitonin gene-related peptide inhibitors are the newest class of drugs to be FDA-approved for migraine.
They are the first class of drugs specifically developed as targeted therapy for migraine.
CGRP is a protein that is released during migraine attacks.
CGRP inhibitors block this protein to help prevent (and sometimes also treat) migraine.
It is injected once a month under the skin of the abdomen, thigh, or upper arm.
Common side effects are injection site reactions (such as pain and redness) and constipation.
Ajovy
Ajovy (fremanezumab-vfrm) is an injectable medicine used to prevent migraine in adults.
It is injected once monthly under the skin of the abdomen, thigh, or upper arm.
Alternatively, a higher dose may be injected every three months.
Injection site reactions are the most common side effect.
Emgality
Emgality(galcanezumab-gnlm) is an injectable medicine used to prevent migraine in adults.
It can also be used to treat episodic cluster headaches.
For migraine prevention, the first dose is a onetime higher dose of 240 milligrams (mg).
This is called a loading dose.
Then, the regular dose of 120 mg is injected every month.
Emgality is injected under the skin of the abdomen, thigh, buttocks, or upper arm.
Injection site reactions are the most common side effect.
It is FDA-approved to prevent episodic migraine in adults.
For this use, it is taken every other day.
It can also be taken as needed for acute migraine treatment.
However, no more than 18 doses can be taken in 30 days.
Common side effects include nausea, stomach pain, and indigestion.
Common side effects include nausea, constipation, and drowsiness/tiredness.
Vyepti
Vyepti (eptinezumab-jjmr) is given by intravenous infusion (into a vein).
It is administered once every three months and takes about 30 minutes to complete.
Common side effects include allergic reactions and symptoms of the common cold.
CGRP Inhibitors for Migraine Prevention
CGRP inhibitors are the newest class of drugs for migraine.
How Long Does It Take to Work?
This may help you notice benefits faster than if you do not keep track.
Doing so can also help you identify and avoidtriggers.
Your healthcare provider can also give personalized medical advice on avoiding and managing triggers.
Consult your healthcare provider for more information and medical advice on migraine prevention.
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